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Pituitary Lymphoma Presenting as Fever of Unknown Origin*

Departments of Medicine (R.E.L., S.L.W., R.J.M., P.U.F.), Radiology (A.G.K.), and Neurosurgery (J.N.B.), Columbia University College of Physicians and Surgeons, New York, New York 10032

Address correspondence and requests for reprints to: Dr. Pamela U. Freda, Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, New York 10032. * Supported in part by a grant from the Endocrine Fellows Foundation (to R.E.L.).

An 86-yr-old woman presented with fever of unknown origin. When laboratory evaluation revealed partial hypopituitarism, a magnetic resonance imaging scan of the head was performed and revealed a sellar mass consistent with a pituitary adenoma. Only after other possible etiologies for fever were excluded did she undergo transsphenoidal resection of the sellar mass, which proved to be a B-cell lymphoma. Primary central nervous system lymphoma of the pituitary region is a rare cause of a sellar mass, and this is the first reported case of pituitary lymphoma whose presenting manifestation was fever of unknown origin. Several disease processes can manifest themselves as fever and a sellar mass, including lymphomas. In our case, only surgical biopsy could make a diagnosis and distinguish this process from the more common pituitary adenoma.

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